Sen. John Cornyn seeks crackdown on health care fraud

When it comes to combating health care fraud, progress is in the eyes of the beholder — and often predictably partisan.

At a Tuesday hearing of the Senate Finance Committee, Chairman Max Baucus, a Montana Democrat, cited statistics indicating progress in reducing fraud that costs the federal government nearly $60 billion a year.

Baucus spoke about the efforts the government has taken to prevent fraud such as giving “law enforcement an unparalleled set of new tools in health reform” that will give them the “authority to stop payment and investigate suspicious claims before taxpayer money goes out the door,” he stated.

Baucus then pointed out impressive statistics, proving his point that these enforcement efforts are making a positive impact. For example, he stated, “last year, the federal government recovered a record of $4.1 billion as a result of health care fraud prevention.”

Federal agencies echoed Baucus’ comments and spoke out about their cooperative efforts to fight health care fraud. They also discussed the problems that fake Medicare suppliers have caused, and stricter enforcement mechanisms for medical companies’ that sell unapproved Medicare plans.

But Republicans had a different perspective. The committee’s top Republican, Orrin Hatch of Utah, expressed his frustrations with the loss of taxpayer dollars and blamed the Centers for Medicare and Medicaid Services (CMS) for not addressing these “waste, fraud and abuse” problems earlier.

After the hearing, Texas Sen. John Cornyn told the Houston Chronicle that it’s vital that “the integrity of Medicare” be preserved mostly “by rooting out and preventing fraud, and technology that detects aberrant behavior can play a key role in this.”

Cornyn also brought up the “recent indictment of a North Texas doctor who allegedly certified over 5,000 patients for home health in one year, far above the typical 100 per year” as an example of poor and fraudulent Medicare billing activity, another reason why this matter of health care fraud still persists as a problem today.